Capnography

[tunnelrat83]

it sounds like a lot of u are just repeating the same thing.. treat your patient.. not the equipment sounds like a lot of people are saying it.. just i don't think i saw it in those words... (although i am running on little sleep so I may have missed it lol)

[skippy]

yes it has it's place and a very big one in our service. We currently use it as much if not more than spo2. we are using it on non intubated pt's that are in resp. distress and this also backs us when we decide to RSI these pt's in resp. distress. Also it is great on intubated pt's for tube confirmation. we have realized that in cases of cardiac arrest that you can ventilate pt's better or just as well and have somewhat better results when waveform capnography is in place

[lil_animal_88]

we have it but the sure fire way is bilateral lung sounds.

thats my story and i am stickin' to it

[Aaron]

We have it on our ALS ambulances, and believe that the life pak 12 has it built in.

Aaron

[Ridryder 911]

I believe we will begin to use the capnography, just as much as we use Sp02 monitor. Unfortunately, there will be just as many of those that will not understand the limits of both devices. I continue to see both EMS & Nurses & even Physicians who do not understand pulse oximetery. Not realizing hypovolemia, low Hgb, dehydration, & poor perfusion can alter readings drastically. How many times have you seen as others have posted " tx the device, not the patient" ?.

I hope we will educate EMS personnel better than we did or do on Sp02, and highly suggest using Capnography with wave forms. The type that uses a cannula (bi-furcation type delivers 02 on one side-monitors on the other side) is very helpful for detecting C02 retention. Color metric are O.K. are very limited. Just as any tools they are ASSETS to helping make a diagnosis.

I have enclosed a site you can copy a waveform guide. I laminated and placed on individual units for a quick reference.

Be safe,

Ridryder 911

http://www.medical.phillips.com/us/products/resucitation/assets/docs/Capnography_Quick_Guide.pdf

[emsgirl]

I actually had a very good Lecture on Capnography presented to my medic class by one of the local fire cheifs who is a paramedic. There some very interesting things breing brought out about it. Such as using it as a tool to help call codes in the field, and actually how it helps in predicting where the code is going. The paticular benefit is in PEA there where actually be a rise in the ETCO2 before you get pulses back. You get teh initial rise when you intubate, and then there will be another rise just before pulses return,.

[Ace844]

You know, this a very useful tool and in IMHLO a welcome addition to our EMS treatment toolbox. It is an out standing adjunct both in conjunction with SPo2, and ET CO2, which as previously mentioned by both Richmond and USAF, with very useful basic info. from both of them on uses, etc... the ET part of ETCO2 doesn't necessarily mean "Endo-tracheal" only. So first bit I think would be is for those who will be using them to get educated on the what/how/when/limits, etc... of the equipment/tools with which we use. In short EDUCATE YOURSELF, ASK ?'s, READ, REPEAT THE PRECEEDING 3, KNOW YOUR LIMITS AND THE LIMITS OF WHAT YOU KNOW AND USE!!!!

Out here,

Ace

[John]

EMSLive hosts a live online radio show each Tuesday night at 9 EST. If you miss the live show, you can catch it in our archives:

Here is the live stream for Tuesday shows:

http://www.emslive.com/onair.mov

Enter this into your QuickTime or Realplayer

[Ridryder 911]

Good show, John.. tried to get in live chat room.. maybe try next week. Keep-up the good work..

Be safe,

Ridryder 911

[Off Label]

If it doesn't delay care or is too expensive, ETCO2 can be useful. Interfacility  or prolonged transport of intubated patients would benefit from the enhanced safety if immediate recognition of an extubation. Correct tube placement in a patient not in full arrest is easier to confirm with ETCO2.

For systems that don't have long transport times or intubations, not worth it. Nasal cannula or mask ETCO2 sets are just really expensive respiratory monitors. Very much qualitative as opposed to quantitative.